This is an extremely innovative project to refine a theory driven online previsit assessment of child passenger safety for 0-8 year old children that results in tailored safety messages presented on an individualized portal for the family, messages for clinicians tailored to prompt discussion of perceived barriers to safety practices during well child visits and resulting reminder messages in a portal that provides repeat reminders and social network support for optimizing family safety measures. The goal is to use state of the art knowledge of behavior change to improve child passenger and other safety practices with potentially enormous impact on the number one cause of morbidity and mortality of children beyond the newborn period. The proposal builds on prior work, including 1) a system called CHADIS (Child Health and Development Interactive System) that delivers a comprehensive array of web-based pre-visit parent questionnaires with linked decision support and resources for clinicians now in use in practices nationally;and 2) materials developed from prior research on parent safety education conducted by the Center for Injury Research and Policy at Johns Hopkins University. In Phase 1 we will refine a theory driven parent assessment of child passenger safety practices through an iterative process of cognitive interviews in order to create tailored safety messages specific to child age, sociodemographics, and parental beliefs and perceived barriers. We will also create a basic parent web portal mechanism to deliver them to individual parents. In Phase II we will complete the system for delivering these tailored messages prior to check ups, prompts for clinicians to address perceived barriers during visits, and reminders and follow through supports via the portal to facilitate safety behavior change after the visit including creating a social network. The portal will also contain a reframed narrative of the child derived from parent questionnaire input to form a printable Memory Book which will attract return visits to the site and its safety messages. Phase II will include a randomized control trial (RCT) of 1200 children using either the new assessment plus the Enhanced web-based system, the new assessment but Standard American Academy of Pediatrics handouts, or usual care Control practices. ABP safety QI certification and sponsorships for the portal will be sought in Phase III. PUBLIC HEALTH RELEVANCE: This project will create a theory driven and tested online pre-visit assessment of child passenger safety for 0-8 year old children that results in tailored safety messages presented on a patentable individualized "baby book" type portal for the family, and also messages for clinicians tailored to prompt discussion of perceived barriers to safety practices during well child visits and resulting reminder messages in a portal that provides repeat reminders and social network support for optimizing family safety measures. The goal is to use state of the art knowledge of behavior change to improve child passenger and other safety practices in conjunction with innovative technology to leverage routine child care for purposes of impacting on the number one cause of morbidity and mortality of children beyond the newborn period.